A manual of obstetrics . quarter ofa circle. The occiputnow is turned towardthe maternal thighcorresponding to theside of the pelvis in which it originally lay — in thisposition the left—while the face is directed to the rightthigh. This movement is produced by rotation of theright shoulder anteriorly upon the pelvic floor. The rightshoulder first striking the perineum to the right of theanteroposterior diameter of the pelvis, it is rotated ante-riorly under the symphysis, but in a reversed directionfrom that taken by the head—namely, from the right tothe left. The bisacromial diameter now cor
A manual of obstetrics . quarter ofa circle. The occiputnow is turned towardthe maternal thighcorresponding to theside of the pelvis in which it originally lay — in thisposition the left—while the face is directed to the rightthigh. This movement is produced by rotation of theright shoulder anteriorly upon the pelvic floor. The rightshoulder first striking the perineum to the right of theanteroposterior diameter of the pelvis, it is rotated ante-riorly under the symphysis, but in a reversed directionfrom that taken by the head—namely, from the right tothe left. The bisacromial diameter now corresponds to theconjugate diameter of the pelvic outlet, and the right oranterior shoulder is in relationship with the symphysispubis. Owing to the softness of the tissues of the shoulder,this rotation is not in every instance as complete as is theanterior rotation of the head. (6) Birth of the Shoulders.—The question as to which shoulder first appears at thevulvar orifice has been very fairly tested by Edgar in a. G 60.—Restitution. EUTOCIA, OR NORMAL LABOR. 143 series of observations, the result of which he reported atthe eighteenth annual meeting of the American Gyneco-logical Society. He has found that in spontaneous deliveryin primiparae the two shoulders appear first at the outletwith about equal frequency, while in multiparae the pos-terior shoulder is seen first most commonly. In bothclasses of patients the left or posterior shoulder is bornfirst in the great majority of the cases—three and one-halftimes as frequently as the anterior in primiparae, and twoand one-half times as frequently as the anterior in multip-arae. {j) Expulsion of the Trunk.—This is rapidly accom-plished by a spiral movement, the body of the child almostfalling into the hands of the obstetrician. Mechanism of the Second Position, Right Occipitoanterior—R. 0. A. (Fig. 61).—This is the third position in frequency;occurring in about 10 per cent, of allcases. Diagnosis.— Vaginal exam
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Keywords: ., bookcentury1800, bookdecade1890, booksubjectobstetrics, bookyear1
